Has anyone had this type of hip flexor pain before?

[fallstoclimb]

I'm having trouble googling it but it's so specific I'm sure it must be an easily-diagnosable issue. Basically, if I'm standing straight up and raise my knee to a 90 degree angle with my hip, I feel a sharp pain in the tenden right below my hip joint. I'm thinking its my hip flexor. It's been bad for about 6 months but I've mostly ignored it, because with the exception of that specific movement it only hurts when I do a lot of hill climbing, or when I ride horses without stirrups. Last night I went to my first cross fit class though, and the v-lifts hurt since of course that is the exact movement that irritates it.

I wonder if there's PT at home I could do to treat it. It's been sticking around for a while. I tried a week of rest once or twice and that didn't fix it so I decided ignoring it was my best option....

[indysteel]

Yes and was ultimately diagnosed with "gluteal amnesia" or "dumb butt syndrome." Essentially, my right glute was no longer firing properly and my hip flexor was overcompensating. Most of the exercises I did were designed to help me relearning gluteal engagement and to strengthen it, too.

Given how long you've been suffering from it, do yourself a favor and be evaluated by a sports medicine doc and/or a PT. Any number of things could be at issue. I waited far too long to be seen and could have avoided a lot of pain, discomfort and inactivity if I'd just started PT earlier. I also set the stage for other compensation issues with that side of my body, e.g., tendonitis where my glute meets my hamstring.

[fallstoclimb]

LOL! That's one of the best diagnoses I've heard. Sorry you went through it though!!

I am thinking I need to see a PT. It's pretty bad today, although that is undoubtedly due to crossfit. I am just so resistant to being told to rest this month.

[Helene2013]

I had something similar to this for a few months on my left hip. In my situation it was created by a right knee injury. I'd put more weight/pressure on the left side to give a break to my right knee. All this to say that at my last PT appointment (for my knee and elbow) I mentionned this to my therapist. She knew exactly what it was. She got me on my back, she did a few checks - like checking my hips alignment and then some "relaxing" exercises and then while keeping me talking, she pulled on that other side and a "crack" was felt and heard. Hubby sitting on a chair near table heard it too. She then applied some "shocks" to that area and since then I have been pain free. So it was something that got somehow misaligned in that hip due to "bad" posture. It's been 2 weeks since visit and the pain that was there for over 3 months....is barely noticeable now. I can climb stairs and do other things easier. But she said it will remain "fragile" for now and should see her again if it comes back. In the meantime, I have to think to bear the weight on both legs (the right knee is almost back to normal).

So it maybe something to have looked at. I thought it would go away on its own, taking Aleve, etc... it did and would not. A simple manipulation and a few exercises were needed to help that hip.

Good luck.

[indysteel]

LOL! That's one of the best diagnoses I've heard. Sorry you went through it though!!

I am thinking I need to see a PT. It's pretty bad today, although that is undoubtedly due to crossfit. I am just so resistant to being told to rest this month.

It could very well be that rest is not the Rx, but better to find out what's wrong than to keep doing what you're doing.

[Blueberry]

I second seeing a PT. I am currently being treated for patella femoral syndrome (knee pain from bad knee alignment - from some of the same issues - different manifestation). The last thing most PT's will do is bench you unless they really need to. I'm allowed to exercise - but am to avoid things that aggravate my knees. So - there's a lot I *can* do. Also - sometimes a short period of rest = less overall time for recovery. Something to think about!

[marni]

having a lot of hip flexor and knee pain due to previous injuries I am a firm believer in foam rolling but then I know why I hurt and have done the PT. Get a diagnosis first but I'm here to say foam rolling and stretching are never bad things.

[Wahine]

I'm having trouble googling it but it's so specific I'm sure it must be an easily-diagnosable issue. Basically, if I'm standing straight up and raise my knee to a 90 degree angle with my hip, I feel a sharp pain in the tenden right below my hip joint. I'm thinking its my hip flexor. It's been bad for about 6 months but I've mostly ignored it, because with the exception of that specific movement it only hurts when I do a lot of hill climbing, or when I ride horses without stirrups. Last night I went to my first cross fit class though, and the v-lifts hurt since of course that is the exact movement that irritates it.

I wonder if there's PT at home I could do to treat it. It's been sticking around for a while. I tried a week of rest once or twice and that didn't fix it so I decided ignoring it was my best option....

I have read the other responses here and I will +3 (2? I lost count) PT. You are definitely showing signs of a muscle imbalance that needs to be addressed. It could even be "dumb butt syndrome", it's kind of an epidemic really.

[fallstoclimb]

Thanks for the replies everyone. I will definitely follow up with at least one PT session. Hopefully I can continue with it beyond that at home on my own...

[maillotpois]

I'd second the suggestion of going to a sports med doctor - and I would suggest doing that before jumping into PT. I had very similar presentation (pain on the upstroke of the pedal when the hip is bent 90 degrees or more as you describe) - I had low level on and off pain for 10+ years, increasing in frequency and intensity over the last year to where I really couldn't cycle anymore. Turned out to be femoral acetabular impingement (basically a big bone spur leading to a large hole in the femur and a torn labrum) and I had surgery in July. I'm on the road to recovery and the hip honestly felt better the day after surgery than the day before.

So, anyway, I hope yours is simply a muscle imbalance, but it wouldn't hurt to get get really checked and get an x-ray because if I had tried to heal my issue with PT alone, I would have done a lot more damage to the hip joint and the femur.

[gnat23]

Look up: anterior femoral glide syndrome

I felt like the clouds had parted and the sun finally shown through when I discovered this.

-- gnat!

[kris7047th]

OMG !! This possibly explains the pain that I had last July for about a month. The first week was no fun .. sharp pain where the leg /torso connect making it difficult and painful to raise/move my left leg especially in the morning the first week. Biking actually helped. I thought it was related to the back surgery/issues .. maybe not. I am fine now.

http://singaporepersonaltrainer.blogspot.com/2008/03/singapore-fitness-coach-talk-rehab.html

16688

[Wahine]

I'd second the suggestion of going to a sports med doctor - and I would suggest doing that before jumping into PT. I had very similar presentation (pain on the upstroke of the pedal when the hip is bent 90 degrees or more as you describe) - I had low level on and off pain for 10+ years, increasing in frequency and intensity over the last year to where I really couldn't cycle anymore. Turned out to be femoral acetabular impingement (basically a big bone spur leading to a large hole in the femur and a torn labrum) and I had surgery in July. I'm on the road to recovery and the hip honestly felt better the day after surgery than the day before.

So, anyway, I hope yours is simply a muscle imbalance, but it wouldn't hurt to get get really checked and get an x-ray because if I had tried to heal my issue with PT alone, I would have done a lot more damage to the hip joint and the femur.

Going to a Sports Med Doc is never a bad choice. Having said that, in general unless the issue is severe with significant bone defects (as was the case with maillotpois) you will usually be sent for conservative PT treatment first. Unless you get a really sh!tty PT, they shouldn't make it worse. If the PT doesn't work, then it's back to the doc to discuss other options.

I've seen a lot of people with this type of injury, I'd say that more than half of them manage really well without surgery. Of the surgery clients I've seen, about half of those do extremely well. Of the ones that are left you'll occasionally see one that is actually worse after the surgery than they were before and usually that's because they ignored some serious precautions after the surgery because they wanted to get back to cycling too early.

So yes, you want to explore the treatment for all your muscle imbalances, weaknesses etc before jumping in to surgery but sometimes it's inevitable and when it is, surgery is often a glorious relief.

[Skippyak]

Try the couch fleoxr stretch http://www.youtube.com/watch?v=-ZX1QMTdAC4 this is an OMG for me, I am one unstretched human being.

[Wahine]

Try the couch fleoxr stretch http://www.youtube.com/watch?v=-ZX1QMTdAC4 this is an OMG for me, I am one unstretched human being.

OMG, I want to hate this video so much because the guy is such a... I want to say douche but that might not be the right word for this forum. But I have to say that it's a good stretch and good advice, if you can get past the douchiness of it all.

[e3rdpower]

OMG, I want to hate this video so much because the guy is such a... I want to say douche but that might not be the right word for this forum. But I have to say that it's a good stretch and good advice, if you can get past the douchiness of it all.

So agree. I'm glad he's made flexibility "cool", but he is a total douche. Excellent choice of words IMO. :D

[fallstoclimb]

Update on my hip flexor: doc thinks it might be a torn labrum and basically told me I'm SOL if that's the case. Said it would be time to move to "low impact" activities, although I'm only 29 and cycling is pretty darn low impact, so I wasn't real impressed with that. I'm getting an MRI in a couple of weeks and then we'll see -- if no tear, I'll go to PT, so here's hoping....

[OakLeaf]

Keeping my fingers crossed for you.

I think it helps to find a rehab specialist (whether it's a physician, PT or some other specialty) who participates in your sports, or failing that, who is an athlete of any kind. Otherwise they tend to take the attitude that you should be glad you can get out of bed unassisted and wipe your own butt, since they deal with so many people who can't. Preventing yourself from getting into that position just isn't in a lot of their vocabulary. You might ask around through your local clubs or shops.

Hope the MRI shows no tear and PT is effective.

[Catrin]

Hopefully there is no no tear! I do, however know several who did that and had successful repairs. They are now just as active as before. Sending you good thoughts and hope PT is all that is needed.

I hear you Oak, I've had a PT imply that about my shoulder and say that I just shouldn't worry about it and not do what hurts it. Well, if I were to follow that attitude then the time would come when I can no longer do anything with it!

[fallstoclimb]

Hopefully there is no no tear! I do, however know several who did that and had successful repairs. They are now just as active as before. Sending you good thoughts and hope PT is all that is needed.

This is another reason I'm not thrilled with the doc, he brushed off the idea of surgery entirely -- "there are surgeries, but you won't be interested in that." Obviously I don't WANT surgery, but what I want least of all is to have to limit my biking! Although I do see his point that its maybe not yet painful enough yet to warrant the surgery. I don't know. I trust his ability to read the MRI so we'll just see what that says and move forward from there.

[maillotpois]

My impingement caused a torn labrum and that was fixed as part of my surgery. If there is a tear, I think it's probably very important to find out why - is there a mechanical defect that would re-injure the labrum even if you were able to fix it through PT, or is it something that occurred because of trauma or some other thing? I have 2 other friends (both exactly my age) who had the same issues as I did (but without the large bone cyst) and they were both repaired arthroscopically and they're doing great.

As several have mentioned (including me, I think, and if I didn't I will say it now) - surgery is a last resort for sure. But if there is something in there that you cannot fix with PT I cannot recommend enough getting it fixed. I also highly recommend getting a second opinion. My original orthopedic surgeon who diagnosed my problem seemed hesitant about operating. I know this is a relatively new procedure to fix these things arthroscopically and so he and I had a really good grown up conversation where he admitted he thought I would be a great surgical candidate but that he wasn't the guy for the job and he recommended the guy who did the surgery. It will drag the process out to talk to more than one doctor, but it's better than rushing into something.

I'm less than 2 months post surgery and am up to 60 miles on the bike and 10 miles hiking. Mine was so painful that I was literally unable to cycle for the 2 - 3 months before surgery. So you need to evaluate where you are on the pain scale, obviously.

[snapdragen]

I'm another one of MP's friends with a labral tear. :D My original ortho guy was upfront and said he did not do this type of surgery. My primary doc searched and found my current ortho at Stanford, I love him. I've had 16 weeks of PT, and now I'm working with a personal trainer to strengthen my legs/hips etc. My new ortho wants to do everything possible before considering surgery, which is fine with me. I've had too many trips to the OR in the last few years. :)

[Skippyak]

Is this a sports ortho? Doesn't sound like it, find an ortho that deals in sports and athletes and injuries. Doesn't have to be a surgeon unless surgery is indicated, of course the issue with surgeons is that his how they work. I cannot believe the ortho just writes you off, as if you were an obese sedentary oldie.

[Wahine]

Yes to continuing to try to work on this with PT. Surgery should be a last resort but I've had several patients that have come to me and eventually gone for surgery and have done very well post surgery. So yes, you need to find a doc that would consider surgery if needed.

Meanwhile, there are some bike fit issues that can be addressed, like a shorter crank arm length and a more upright posture.

This is the link to find a Bike PT in your state (http://bikept.com/find-a-bikept-pro/), if you're interested.

[maillotpois]

I know I'm the "last resort" person weighing in as I did have surgery, but just wanted to report that almost 3 months post surgery and I'm up to 60 miles on the bike and 10 - 12 miles hiking with minimal pain. There's plenty of "you're out of shape" pain (sore legs and back and muscles around the hip), but no more of the "wow you are doing real damage" pain (shooting pain with every up pedal stroke) I had before surgery.

I'm hoping your PT eval and visits are going well and you can avoid surgery, but for me it was a GREAT option.

[snapdragen]

I know I'm the "last resort" person weighing in as I did have surgery, but just wanted to report that almost 3 months post surgery and I'm up to 60 miles on the bike and 10 - 12 miles hiking with minimal pain. There's plenty of "you're out of shape" pain (sore legs and back and muscles around the hip), but no more of the "wow you are doing real damage" pain (shooting pain with every up pedal stroke) I had before surgery.

I'm hoping your PT eval and visits are going well and you can avoid surgery, but for me it was a GREAT option.

Yabbut, you're an Amazon. :D

[maillotpois]

Yabbut, you're an Amazon. :D

:p


:)

[fallstoclimb]

Update on this, I got an MRI and there's no sign of a tear. Doctor says we could do an MRI with contrast just to make sure, but he thinks its more likely hip tendonitis so we're going to start PT first. Here's hoping that helps!

[OakLeaf]

Good news! Good luck with the PT.

[maillotpois]

Very good news! Good luck - I'm sure you'll do great in PT.

[Wahine]

Great news! Here's to starting on your rehab and getting back to the active person you want to be!